Secure, durable, reliable vascular access has become one of the most central requirements for continuing management of children with Intestinal Failure and the need for continuing parenteral nutrition. The secure placement and maintenance of vascular access devices has many potential vulnerabilities including inadequate vascular anatomy, infection, catheter dislodgement or damage, fibrin sheath, and many others. The modern ability to maintain these implanted devices for many years stands as a testimony to the multidisciplinary efforts that have addressed each aspect of vessel and catheter preservation. In most institutions regularly treating children with intestinal failure, guidelines have been proposed regarding the placement of catheters, the types of catheters used, and the care and use of the catheters. This continued strict adherence to protocols has been shown to have dramatic effects in extending the lifespan of a useful catheter.
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